{include file="public/same_header" /}
    <!-- 左侧的结束 -->

    <!-- 右侧的开始 --><!-- hou_yszhguanli 后台的 医生账户管理 -->
    <div class="right_bar jianchajilu add_menber_html huanzhe_bianji">
        {include file="public/main_bread" /}
        <form action="" class="horizontal" method="post" role="form" >
            <div class="data">
                <div class="center">
                    <div class="right">
                        <ul>
                            <li>
                               
                                    <span>姓名：</span>

                                <div class="right">
                                    <input type="text" name="name"  value="{$list['name'] ?? ''}">
                                </div>
                            </li>
                            <li>
                                   
                                    <span>性别：</span>

                                <div class="right">
                                    <select name="sex" id="sex">
                                        <option value="1" {if condition="isset($list['sex']) && $list['sex'] eq 1"}selected{/if}>男</option>
                                        <option value="2"  {if condition="isset($list['sex']) && $list['sex'] eq 2"}selected{/if}>女</option>
                                    </select>
                                </div>
                            </li>
                            <li>
                               
                                   
                                    <span>证件类型：</span>

                                <div class="right">
                                    <select name="document_type" id="document_type" >
                                        <option value="1"  {if condition="isset($list['sex']) && $list['sex'] eq 1"}selected{/if}>身份证</option>
                                        <option value="3"  {if condition="isset($list['sex']) && $list['sex'] eq 3"}selected{/if}>港澳通行证</option>
                                        <option value="2"  {if condition="isset($list['sex']) && $list['sex'] eq 2"}selected{/if}>护照</option>
                                    </select>
                                </div>
                            </li>
                            <li>
                               
                                   
                                    <span>证件号：</span>

                                <div class="right">
                                    <input type="text" id="idcard" name="document_num" value="{$list['document_num'] ?? ''}">
                                </div>
                            </li>
                            <li>
                               
                                   
                                    <span>出生日期：</span>

                                <div class="right">
                                    <script type="text/javascript">
                                        $(function(){
                                            $('.end_date_picker').date_input();
                                        })
                                    </script>
                                    <div style="" class="input_box">
                                        <input  style="" type="text" class="end_date_picker"  value="{$list['birth'] ?? ''}" id="input1" name="birth">
                                    </div>
                                    <script>
                                        $("#idcard").blur(function () {
                                            //选择的身份证才进行验证
                                            // alert($('#document_type option:selected').val());
                                            if ($('#document_type option:selected').val() == '1') {
                                                checkIdCard();
                                            }

                                        });
                                    </script>
                                </div>
                            </li>
                            <li>
                                    <span>预留手机号：</span>
                                <div class="right">
                                    <input type="text" name="phone" value="{$list['phone'] ?? ''}">
                                    <input type="hidden" name="doctor_id" value="{$list['doctor_id'] ?? ''}">
                                </div>
                            </li>
                        </ul>
                    </div>
                    <div class="save_or_no">
                        <a  class="cirtain">
                            <input type="button" class="ajax-post" value="保存">
                        </a>
                        {include file="public/cancel_list" /}
                    </div>
                </div>
            </div>
            </form>
        </div>
    </div>
    <!-- 右侧的结束 -->
</div>
</div>

{include file="public/footer" /}